"The changing competitive landscape in procurement of scheduled medicines in the private pharmaceutical industry of South Africa."

Abstract

"The private pharmaceutical industry of South Africa consists of various players such as buyers, suppliers and intermediaries in the procurement system who constitute the domestic part of a global pharmaceutical value chain. An interesting fluctuation of power dynamics between various players in the procurement system was observed as the part and vital conduit for government to achieve improved geographical access to affordable medicine in outlying areas. players competed for power with the intent to capture maximum profit margin relative to their position in the value chain. The purpose of this research study is to explore the potential causes that explain the changing competitive landscape in procurement of scheduled medicine in the private pharmaceutical industry of South Africa. Furthermore, the research aims to establish if and how the current state of competition between players in the procurement system are expected to change in the context of national health insurance and centralised procurement. The research study made use of a qualitive research methodology and data was collected through eleven interviews with leaders of businesses across the procurement system of the private pharmaceutical industry of South Africa. Participants were selected with the use of a purposive sampling strategy. The study found that that NHI will drive the SA government to engage in a contractual arrangement with players in the procurement system of the private pharma industry in SA namely: distributors, wholesalers, and pharmacies. The purpose of the contractual arrangement will be to reach an agreement with the players in the procurement system whereby they open-up their distribution and dispensing services to all members of NHI with the objective of achieving universal health coverage for the broader population and work towards bringing the economic segregation between public and private patients to an end. That the power that medical aids currently wield in the selection of the specific type of product that the patient receives at the point of dispensing will diminish significantly. That the role of medical aids could potentially be limited to serving the SA government as business administrators for the NHI. Also, that large corporate pharmacy groups are anticipated to wield significant bargaining power in the context of NHI and centralised procurement as, although government will look to exert institutional power on the corporate pharmacy groups, the reality is that their vast distribution infrastructure, and prolific number of stores positions the corporate pharmacy groups as an integral part and vital conduit for government to achieve improved geographical access to affordable medicine in outlying areas.